1. Technical Field
The present disclosure relates to methods and apparatuses for repairing and/or altering cardiac tissue such as a valve, including valve leaflets such as coapting valve leaflets.
2. Background
Surgical procedures such as heart valve repair and/or replacement are effective in treating heart valve incompetence (regurgitation, insufficiency) and/or damaged heart valves. However, such techniques are problematic in that invasive surgery is required to reach the valves with a surgical instrument. For example, in order to perform mitral valve surgery, a surgeon may be required to make large openings in the chest to access the mitral valve through a left atriotomy. Further, one or more large openings in the chest may be needed to cannulate the aorta and vena cavae to manipulate surgical instruments, to stop the heart during a cardiac procedure, and to repair or replace a heart valve. Such procedures result in significant trauma and metabolic derrangment to the patient and may not be appropriate for some patients such as the elderly, or patients with significant cardiac disease and/or other diseased states.
Currently, open surgical repair of damaged or incompetent heart valves employs a variety of techniques including annuloplasty rings, excision of damaged or prolapsing leaflets, transfer of chordae tendinae, artificial chordae tendinae, and edge-to-edge leaflet repair. Some of these methods for open surgical heart valve repair may be amendable to less invasive approaches such as beating heart surgery, minimally invasive surgery, thorascopic surgery, or endovascular approaches. One technique for open surgical valve repair in particular, known as the Alferi or edge-to-edge repair, might be accomplished by less invasive approaches. The edge-to-edge repair involves the fusion of opposing (facing) valve leaflets to correct valve incompetence secondary to leaflet prolapse. Current methods for edge-to-edge repair employ either classic surgical suturing with suture materials or surgical staples to accomplish leaflet fusion.